A Zebra Among the Horses: Clinical Implications of Malaria in the United States
Authors: Ralph Huits, Erika Wallender, Kristina M. Angelo, Michael Libman, Davidson H. Hamer
Journal: Annals of Internal Medicine (2023)

Ideas and Opinions25 July 2023A Zebra Among the Horses: Clinical Implications of Malaria in the United StatesRalph Huits, MD, PhD, Erika Wallender, MD, MPH, Kristina M. Angelo, DO, MPH&TM, Michael Libman, MD, and Davidson H. Hamer, MDRalph Huits, MD, PhDDepartment of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy (R.H.), Erika Wallender, MD, MPHMalaria Branch and Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia (E.W.), Kristina M. Angelo, DO, MPH&TMDivision of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia (K.M.A.), Michael Libman, MDJ.D. MacLean Centre for Tropical Diseases, McGill University Health Centre, Montreal, Quebec, Canada (M.L.), and Davidson H. Hamer, MDDepartment of Global Health, Boston University School of Public Health; Section of Infectious Diseases, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine; Center for Emerging Infectious Disease Policy and Research, Boston University; and National Emerging Infectious Disease Laboratory, Boston, Massachusetts (D.H.H.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M23-1871 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail On 26 June 2023, the U.S. Centers for Disease Control and Prevention (CDC) issued a Health Alert Network report about locally acquired, mosquito-transmitted Plasmodium vivax malaria. As of 19 July 2023, 7 cases in Florida (Sarasota County) and 1 in Texas (Cameron County) had been reported. Of note, the Texas case is unrelated to the Florida cases. All of the patients received treatment and have recovered. Active surveillance for additional cases by the state health departments and mosquito control measures are ongoing (1).This is the first time since 2003 that locally acquired, mosquito-transmitted malaria has been documented in the ...References1. CDC Health Alert Network. Locally Acquired Malaria Cases Identified in the United States. Centers for Disease Control and Prevention; 26 June 2023. Accessed at https://emergency.cdc.gov/han/2023/pdf/CDC_HAN_494.pdf on 28 June 2023. Google Scholar2. Dye-Braumuller KC, Kanyangarara M. Malaria in the USA: how vulnerable are we to future outbreaks? Curr Trop Med Rep. 2021;8:43-51. [PMID: 33469475] doi:10.1007/s40475-020-00224-z CrossrefMedlineGoogle Scholar3. Thomson MC, Stanberry LR. Climate change and vectorborne diseases. N Engl J Med. 2022;387:1969-1978. [PMID: 36416768] doi:10.1056/NEJMra2200092 CrossrefMedlineGoogle Scholar4. Mace KE, Lucchi NW, Tan KR. Malaria surveillance - United States, 2018. MMWR Surveill Summ. 2022;71:1-35. [PMID: 36048717] doi:10.15585/mmwr.ss7108a1 CrossrefMedlineGoogle Scholar5. World Health Organization. World Malaria Report 2022. Accessed at www.who.int/teams/global-malaria-programme/reports/world-malaria-report-2022 on 17 July 2023. Google Scholar6. Brown AB, Miller C, Hamer DH, et al. Travel-related diagnoses among U.S. nonmigrant travelers or migrants presenting to U.S. GeoSentinel sites - GeoSentinel Network, 2012-2021. MMWR Surveill Summ. 2023;72:1-22. [PMID: 37368820] doi:10.15585/mmwr.ss7207a1 CrossrefMedlineGoogle Scholar7. Daily JP, Minuti A, Khan N. Diagnosis, treatment, and prevention of malaria in the US: a review. JAMA. 2022;328:460-471. [PMID: 35916842] doi:10.1001/jama.2022.12366 CrossrefMedlineGoogle Scholar8. Prestel C, Tan KR, Abanyie F, et al. Malaria diagnostic practices in U.S. laboratories in 2017. J Clin Microbiol. 2018;56. doi:10.1128/JCM.00461-18 CrossrefMedlineGoogle Scholar9. Frosch AE, Thielen BK, Alpern JD, et al. Antimalarial chemoprophylaxis and treatment in the USA: limited access and extreme price variability. J Travel Med. 2022;29. [PMID: 34343310] doi:10.1093/jtm/taab117 CrossrefMedlineGoogle Scholar10. Spanakos G, Snounou G, Pervanidou D, et al; MALWEST Project. Genetic spatiotemporal anatomy of Plasmodium vivax malaria episodes in Greece, 2009–2013. Emerg Infect Dis. 2018;24:541-548. [PMID: 29460743] doi:10.3201/eid2403.170605 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Ralph Huits, MD, PhD; Erika Wallender, MD, MPH; Kristina M. Angelo, DO, MPH&TM; Michael Libman, MD; Davidson H. Hamer, MDAffiliations: Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy (R.H.)Malaria Branch and Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia (E.W.)Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia (K.M.A.)J.D. MacLean Centre for Tropical Diseases, McGill University Health Centre, Montreal, Quebec, Canada (M.L.)Department of Global Health, Boston University School of Public Health; Section of Infectious Diseases, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine; Center for Emerging Infectious Disease Policy and Research, Boston University; and National Emerging Infectious Disease Laboratory, Boston, Massachusetts (D.H.H.)Financial Support: Drs. Huits, Libman, and Hamer are supported by cooperative agreement U01CK000632-01-00 between the Centers for Disease Control and Prevention and the International Society of Travel Medicine.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M23-1871.Corresponding Author: Davidson H. Hamer, MD, Department of Global Health, Boston University School of Public Health, Crosstown 308, 801 Massachusetts Avenue, Boston, MA 02118; e-mail, dhamer@bu.edu.Author Contributions: Conception and design: R. Huits, K.M. Angelo, M. Libman, D.H. Hamer.Analysis and interpretation of the data: E. Wallender, D.H. Hamer.Drafting of the article: R. Huits, E. Wallender, K.M. Angelo, M. Libman, D.H. Hamer.Critical revision for important intellectual content: R. Huits, E. Wallender, K.M. Angelo, M. Libman, D.H. Hamer.Final approval of the article: R. Huits, E. Wallender, K.M. Angelo, M. Libman, D.H. Hamer.Obtaining of funding: D.H. Hamer.Administrative, technical, or logistic support: E. Wallender, K.M. Angelo, D.H. Hamer.Collection and assembly of data: E. Wallender.This article was published at Annals.org on 25 July 2023. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAnnals On Call - Malaria in the United States Robert M. Centor , Davidson H. Hamer , and Ralph Huits Metrics September 2023Volume 176, Issue 9 Page: 1269-1270 Keywords Global health Infectious disease control Infectious diseases Malaria Plasmodium Prevention, policy, and public health Tropical diseases Zoonoses ePublished: 25 July 2023 Issue Published: September 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...